THE EFFECTIVENESS OF NON-PHARMACOLOGICAL INTERVENTIONS ON SLEEP QUALITY IN RA AND FMS: A SYSTEMATIC REVIEW

Abstract Objective Sleep disturbances can significantly impact the well-being of individuals with Rheumatoid Arthritis (RA) and Fibromyalgia (FMS), leading to daytime sleepiness, fatigue, and increased pain. This systematic review aims to assess the available evidence on the effectiveness of non-pharmacological interventions in improving sleep quality for individuals with RA and FMS. Method A comprehensive search was conducted in English electronic databases (CINAHL plus, SPORTDiscus, EMBASE, Medline, PubMed, Web of Science, and Google Scholar) to identify relevant articles. The review includes 15 studies, consisting of 13 randomized controlled trials (RCTs) and 2 non-randomized controlled trials (non-RCTs), published between 2012 and 2022. Primary and secondary outcome measures related to sleep quality were assessed using subjective and objective measures. Results Interventions in the studies were diverse, involving physical and mind-body approaches, lasting 6 to 16 weeks with session durations of at least 30 minutes. The total intervention hours ranged from 6 to 32 hours across all studies. Follow-up evaluations were conducted in four studies up to 6 months after the last treatment. While the Arthritis Foundation Exercise Program and Yoga did not report statistically significant improvements in sleep quality for RA, non-pharmacological interventions showed a positive impact on sleep outcomes for RA and FMS populations. Conclusion Non-pharmacological interventions show promise as a potential alternative method to improve sleep quality for individuals with RA and FMS. However, there is no evidence to support the superiority of one intervention over another. Keywords: Rheumatoid Arthritis. Fibromyalgia Syndrome. Sleep quality. Sleep disturbance. Exercise. Non-pharmacological intervention.

exploiting temporal variation in the timing of COVID-19 exposure across participants interviewed from 2018 to 2020 together with the geographical variation in COVID-19 severity at the provincial district level.Overall, the DID estimates showed that the COVID-19 pandemic could significantly increase trust in doctors after controlling for multiple covariates (adjusted β: 0.053, 95% CI: 0.028-0.078).Stratified analyses showed that the effect was only in females and the more educated ones but not in their counterparts.In addition, the COVID-19 pandemic showed a positive effect on trust in doctors among 65-79-year-olds (0.082, 0.056-0.109),but older adults over the age of 80 showed significantly reduced trust in doctors (-0.236, -0.418--0.055).Our findings confirm the association between the COVID-19 pandemic and trust in doctors among older Chinese people.Hospitals and other medical organizations should pay more attention to improving older adults' trust in doctors and building a better physician-patient relationship to face the future pandemic.
Ching-I Chin, New York University, New York City, New York, United States Objective: Sleep disturbances can significantly impact the well-being of individuals with Rheumatoid Arthritis (RA) and Fibromyalgia (FMS), leading to daytime sleepiness, fatigue, and increased pain.This systematic review aims to assess the available evidence on the effectiveness of nonpharmacological interventions in improving sleep quality for individuals with RA and FMS.Method: A comprehensive search was conducted in English electronic databases (CINAHL plus, SPORTDiscus, EMBASE, Medline, PubMed, Web of Science, and Google Scholar) to identify relevant articles.The review includes 15 studies, consisting of 13 randomized controlled trials (RCTs) and 2 non-randomized controlled trials (non-RCTs), published between 2012 and 2022.Primary and secondary outcome measures related to sleep quality were assessed using subjective and objective measures.Results: Interventions in the studies were diverse, involving physical and mind-body approaches, lasting 6 to 16 weeks with session durations of at least 30 minutes.The total intervention hours ranged from 6 to 32 hours across all studies.Follow-up evaluations were conducted in four studies up to 6 months after the last treatment.While the Arthritis Foundation Exercise Program and Yoga did not report statistically significant improvements in sleep quality for RA, non-pharmacological interventions showed a positive impact on sleep outcomes for RA and FMS populations.

Conclusion: Non-pharmacological interventions show
promise as a potential alternative method to improve sleep quality for individuals with RA and FMS.However, there is no evidence to support the superiority of one intervention over another.Keywords: Rheumatoid Arthritis.Fibromyalgia Syndrome.Sleep quality.Sleep disturbance.Exercise.Non-pharmacological intervention.

THE EFFECTS OF EARLY-LIFE ADVERSITY ON WOMEN'S COGNITIVE HEALTH AFTER AGE 50 Kimson Johnson, University of Michigan, Ann Arbor, Michigan, United States
According to the Alzheimer's Association, 6 million people age 65 and older are living with Alzheimer's Disease in the United States, and nearly 4 million are women.Few research studies have examined the impact of adverse childhood events (ACEs) on cognitive health among women over 50.Evaluating gender-specific differences in predictors of cognitive health can help clarify mechanisms that hinder or magnify gender-based health differences and provide information on ways to narrow gender disparities in dementia.The study examined the relationship between ACEs, cognitive impairment, and incident dementia using data from the Health and Retirement Study Cross-wave 2015-2017 Life History Mail Survey (N = 4,980; Mage = 67.6).Cognitive status was measured using the 2016 Langa-Weir three category indicator: Normal, Cognitive Impairment but No Dementia (CIND), and Dementia.Compared to women exposed to 0 ACEs, women exposed to 1 ACE had a higher relative risk for CIND and dementia (RRR=1.71,p<.05; RRR=2.44,p<.05).Women exposed to 3 ACEs had a higher relative risk for dementia (RRR=3.43,p<.05).Non-Hispanic Black women exposed to 3 ACEs had a lower relative risk for dementia (RRR=0.18,p<.05) than white women.Women with 12 years of education have a higher relative risk for CIND and dementia (RRR=2.27,p<.05;RRR=3.45,p<.05)than women with >13 years of education.Although women's life expectancy has increased over the past few decades, women remain at risk for delayed identification of cognitive decline.Future research should examine how other critical social determinants of health influence women's cognitive health after 50.Nursing homes experienced numerous challenges resulting from the COVID-19 pandemic.Among these challenges was ensuring appropriate and effective communication with friends and family members of residents, particularly in light of visitation restrictions.Using qualitative data from 156 in-depth, semi-structured interviews with administrators of 40 nursing homes across the US from July 2020 through December 2021, challenges and solutions to communicating effectively with resident families are characterized.Findings include three themes: 1. Administrators identified best practices regarding the frequency of communicating with families.Particularly early in the pandemic and when visitation was restricted, families expressed a desire for very frequent updates regarding resident well-being and COVID-19.Administrators reported the challenges of balancing family expectations regarding information with their capacity to meet those expectations.2. Administrators discussed different modes of communication used with families.Existing systems of mass-communication were expanded and new processes were developed.3. Administrators described challenges in determining the appropriate content to communicate and navigating changing policies.While nursing home staff were required to share data on COVID-19 outbreaks, administrators shared lessons learned regarding specificity of information to be shared, and how they balanced required infection control information with pleasant updates regarding residents and their activities.Strategies identified by administrators may be informative for efforts to promote effective communication for both general day-to-day updates and for future emergency or pandemic crises.

THE EXPERIENCES OF OLDER ADULTS IN HAITI AND THE UNITED STATES AT THE ONSET OF COVID-19
Laurie Blackman 1 , Kathryn Krase 2 , and Donna Wang 3 , 1. Yeshiva University,New York City,New York,United States,2. Krase Consulting,Brooklyn,New York,United States,3. Springfield College,Springfield,Massachusetts,United States From the early onset of the COVID-19 pandemic, there was a disproportionate risk and impact of the disease on